Health Systems and Policy Research

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Current Status of Nursing Law in the United States and Implications

Juh Hyun Shin, Jungeun Koh, Ha Eun Kim, Ha Jin Lee and Seoungyoon Song

Methods: This systematic review was guided by a preliminary literature review that identified relevant research terms including nurse(ing) staffing, license, certification, healthcare professionals, and nursing law. An online search of the electronic bibliographic databases MEDLINE, CINAHL, OVID, Westlaw (International materials- Jurisdiction), U.S. National Conference of State Legislatures, and Google Scholar yielded journal articles, nursing acts, and websites from 2009 to 2015.
Most nursing laws require staffing committees in each hospital to develop staffing strategies. Staffing committees should include direct-care nurses. Illinois, Oregon, Washington, and Texas require at least 50~60% registered nurses on the committee. Nursing laws in California, New York, and Massachusetts proposed a specific nurse–patient staffing ratio in consideration of the severity of need of patients or units. Furthermore, California enacted minimum staffing ratios. California reported decreased patient mortality, decreased turnover of nursing staff, and increased satisfaction and retention of nurses.
Conclusion: It is timely to have nursing laws worldwide that establish minimum numbers of nurses with professional competencies for the health and safety of global citizens.